Nursing Care Plan For Elderly Patient With Hip Fracture.

Creating a nursing care plan for an elderly patient with a hip fracture involves a comprehensive approach to manage pain, promote healing, prevent complications, and support mobility and independence. Here’s a general outline of such a plan:

      1. Assessment

•    Physical Assessment:  
•   Assess pain levels regularly using a pain scale.
•   Monitor vital signs (especially signs of infection like fever).
•   Check for signs of skin breakdown, especially around the surgical site.
•   Assess mobility and ability to perform activities of daily living (ADLs).
•    Psychosocial Assessment:
•   Evaluate the patient’s emotional state, fear of immobility, or anxiety.
•   Assess social support and living conditions.
•    Nutritional Assessment: 
•  Assess dietary intake, especially protein and calcium, to support healing.

   2. Nursing Diagnoses

• Acute Pain related to hip fracture and surgical intervention.
•   Impaired Physical Mobility related to pain, surgical procedure, and fear of falling.
• Risk for Infection related to surgical wound.
•   Risk for Pressure Ulcers related to immobility.
•   Impaired Skin Integrity related to surgical incision.
•   Risk for Constipation due to immobility and pain medication.

      3. Planning

•   Goals:
•  The patient will report adequate pain control within 24 hours.
•  The patient will demonstrate improved mobility with assistance within 48 hours.
•  The patient will show no signs of infection at the surgical site.
•  The patient will maintain intact skin throughout the hospital stay.
•  The patient will have regular bowel movements within 72 hours.

      4. Implementation

•   Pain Management:  
•  Administer prescribed analgesics as needed.
•  Implement non-pharmacological methods for pain relief, such as ice packs or positioning.
•   Mobility Support:
•   Encourage deep breathing and coughing exercises to prevent pneumonia.
•   Assist with passive range of motion (ROM) exercises.
•  Collaborate with physiotherapists for ambulation and strengthening exercises.
•   Infection Prevention:
•  Perform regular wound care, following aseptic techniques.
•  Monitor for signs of infection, such as redness, warmth, or discharge.
•    Skin Care:  
•  Reposition the patient every 2 hours to prevent pressure ulcers.
•  Use pressure-relieving devices, like special mattresses or cushions.
•    Constipation Prevention:
•   Encourage a high-fiber diet and increased fluid intake.
•   Administer stool softeners or laxatives as prescribed.
•    Patient Education:  
•    Teach the patient and family about safe mobility techniques and the importance of early ambulation.
– Educate on signs of infection and when to seek medical attention.

     5. Evaluation

•    Assess Pain:  
•  Evaluate pain levels before and after interventions to determine effectiveness.
•   Monitor Mobility:  
•  Assess the patient’s ability to perform ADLs and ambulate with or without assistance.
•    Check for Complications: 
•   Regularly inspect the surgical site for signs of healing or infection.
•   Assess Skin Integrity:  
•   Check skin for any signs of breakdown and ensure pressure ulcer prevention measures are effective.
•    Evaluate Bowel Function:  
•   Monitor bowel movements and adjust interventions as needed.

     6. Documentation

•   Record all assessments, interventions, and evaluations.
•   Document pain levels, response to pain management strategies, wound status, mobility progress, and bowel movements.

This care plan should be tailored to the individual needs of the patient and adjusted as their condition improves or if any complications arise.